NPIMap

Individual provider Active NPI

Holly A Graber, PTA

  • Physical Therapy Assistant
  • Bemidji, MN
National Provider Identifier
1376840694
Registry record updated Feb 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
A1442 Issued in MN
Practice address
677 Anne St NW
Suite E
Bemidji, MN 56601-4390
Phone
(218) 444-8280
Fax
(218) 444-8337
NPI assigned
Feb 23, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X A1442 MN Primary

Addresses

Primary practice location

677 Anne St NW
Suite E
Bemidji, MN 56601-4390

Mailing address

677 Anne St NW
Suite E
Bemidji, MN 56601-4390
Phone (218) 444-8280

Other names 1

  • Holly A Littlepage Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
A1442MNMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Choice Therapy, P.a. Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1298419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298419200000",
    "number": "1376840694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "677 ANNE ST NW",
            "address_2": "SUITE E",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566014390",
            "telephone_number": "218-444-8280",
            "fax_number": "218-444-8337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "677 ANNE ST NW",
            "address_2": "SUITE E",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566014390",
            "telephone_number": "218-444-8280",
            "fax_number": "218-444-8337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRABER",
        "first_name": "HOLLY",
        "middle_name": "A",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-23",
        "last_updated": "2011-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MN",
            "license": "A1442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HOLLY",
            "last_name": "LITTLEPAGE",
            "middle_name": "A",
            "credential": "PTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bemidji, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.